Transnasale Chirurgie der Orbita

Abstract

The endonasal surgery has a branch in the transnasal orbital surgery. For this transnasal approach the anterior skull base, the medial and infero-medial orbita, the orbital apex with the optical nerve and the sphenoid sinus are within reach. In all primary and secondary malignant lesions with extension into the orbita, the transnasal biopsy is of importance for diagnosis, particularly in metastasis to the orbit and pseudo-tumors. Benign lesions like mucoceles and osteomas are accessible and fully removable. Good results have been obtained in endonasal orbital decompression and inhomogeneous space occupying intraorbital lesions like bleedings. Among the orbital traumatism, with restrictions fractures of the medial orbital wall, medial orbital floor and foreign bodies could be operated. The transnasal approach is not indicated in all diseases, which are situated mostly intraconally, supraorbitally and lateral of the bulbus as well as in tumors with intracranial extension. In summary, the transnasal orbital approach has its place as helpful addition to the transfacial and transcranial techniques and can even replace them in certain selected indications.

Orbital schwannoma with hyposmia as the only presentation: Case report and a literature review on differential diagnosis

“…Several surgical approaches to the orbit tumors have been reported, such as lateral orbitotomy, trans-conjunctival, supraorbital, pterional, contralateral pterional, and the endonasal approaches. [15][16][17][18] In our case, the mass was located in the intracanal area, so we used intranasal endoscopic ethmoidectomy. Endoscopy permits wide angle and high brightness, leaving no facial scar, and complete tumor removal.…”

Orbital size measurement based on computed tomography imaging for surgical safety

“…Laryngological surgical approaches to the orbit lead through the medial wall (transethmoidal approach) or inferior wall (transantral approach) [3,9,18]. The angles between these walls require different preparation methods.…”

Cranio-Orbital and Orbitocranial Approaches to Orbital and Intracranial Disease: Eye-Opening Approaches for Neurosurgeons

“…The endoscopic endonasal trans-ethmoidal approach is an excellent approach for tumors located inferior and medial to the optic nerve (48,49). Similarly, the endoscopic endonasal transsphenoidal approach provides access to the medial aspect of the orbital apex, where the intracranial and intraorbital optic nerve can be decompressed.…”